President Barack Obama speaks about his signature health care law, Thursday, Nov. 14, 2013, in the Brady Press Briefing Room of the White House in Washington. Bowing to pressure, President Barack Obama intends to permit continued sale of individual insurance plans that have been canceled because they failed to meet coverage standards under the health care law, officials said Thursday. (AP Photo/Charles Dharapak)

As President Obama announced a potential workaround for the Affordable Care Act Thursday, Marin insurance brokers said they are being deluged with requests for help from customers whose health insurance policies have been canceled.

"We are so swamped," said Sue Barstow, who operates Ross Valley Insurance in Fairfax, together with her daughter, Jen Barstow.

"We are just buried," said Noah Petit, a broker with Sadler & Co. in Kentfield.

"It's out of control," said Ross Secor, a health insurance specialist with Minto & Wilkie Insurance Agency in San Rafael.

The millions of people who get health insurance through their employer are unaffected by the dawning of "Obamacare." And many people will be eligible for government subsidies or Medi-Cal, which has been expanded under the new system. For some individuals who purchase their own health insurance, however, the changeover is causing pain.

Jordan Shields, a broker with the SSM Group in Novato, said he recently advised a client, "There is no good news here. It's all bad news. Pay more, get less, see fewer doctors. That is it in a nutshell."

Reacting to growing political pressure due to the number of cancellations, Obama held a press conference Thursday morning to announce that he is urging insurance companies to continue offering all customers the opportunity to keep whatever health plan they now have next year.

Prior to the announcement, Marin brokers said a majority of the cancellations were resulting because insurance companies have reconfigured their offerings to mirror the tiered structure of policies being offered through California's new health insurance exchange, Covered California — not because the plans failed to provide the 10 health benefits deemed essential by the Affordable Care Act.

Under the exchange's tiered structure, plans with the lowest cost and the highest co-pays are listed as "Bronze" plans; plans with the highest cost and the lowest co-pays are referenced as "Platinum" plans. Purchasers who want something that falls somewhere in between have the options of "Silver" and "Gold" plans.

Shields said Kaiser and other insurance companies selling through Covered California have reconfigured all of their offerings, not just those offered via the exchange, to conform to the tiered structure of Covered California. As a result, Shields said the only incentive customers have for purchasing through Covered California is if they think they might qualify for a subsidy.

It's unclear if this reconfiguration came at the initiative of the insurance companies or if the restructuring was unavoidable under the terms of the contract that companies selling through the exchange had to sign.

Anne Gonzales, a Covered California spokeswoman, said there is nothing in the contract that forces companies to adhere to the tiered, metallic structure.

But Chris Stenrud, a spokesman for Kaiser Permanente, said, "There are dozens and dozens of rules that any health plan has to meet under the Affordable Care Act, whether they are in the exchange or not; the net result is that you can really only offer plans that look a certain way, and they tend to look like one another, inside and outside the exchange."

Kaiser has sent cancellation notices to 160,000 people in California, more than half of its individual business in the state. Stenrud said some of Kaiser's policies failed to provide "essential" health benefits; for example, some policies didn't offer maternity care while others offered no prescription drug coverage. He said technically all of Kaiser's individual policies were noncompliant because the fees charged for them were based on customers' medical history, which the Affordable Care Act prohibits.

Stenrud said some of Kaiser's cancellations could have been avoided if Covered California hadn't required all health providers to terminate all non-grandfathered individual plans that fail to comply with the Affordable Care Act by the end of the year. Plans that existed on March 23, 2010, before the act took effect, are grandfathered.

With Obama's announcement Thursday, it appears that insurance companies may be free to renew policies that expire in 2013 for one more year. But Stenrud said Kaiser hasn't yet assessed what the president's policy change will mean here in California.

"We're trying to get more information from the federal government," Stenrud said. "We assume there will be additional conversations with state government and regulators on how this all might all work."

There is no information available on the number of Marin County residents who have had their health insurance policies canceled due to the implementation of the Affordable Care Act. But local brokers say Kaiser is one of three insurance carriers that dominate the Marin market. The California Department of Insurance has recently required the other two predominate Marin companies, Blue Shield and Anthem Blue Cross, to delay the cancellation of some of their policies.

Last week, under threat of a lawsuit by Insurance Commissioner Dave Jones, Blue Shield agreed to permit 115,000 California customers to remain on their current policies until the end of the Affordable Care Act's open enrollment period March 31, 2014. This week, under similar pressure from the California Department of Insurance, Anthem Blue Cross of California announced it will grant a two-month extension through February, 2014 to 104,000 customers. In both cases, the insurance companies were forced to comply with state laws governing how far in advance customers must be notified before policies are canceled.

Broker Shields said he isn't surprised that premiums on the new policies are higher.

"Insurance companies were going to change the rates in 2014 anyway," Shields said. "Anyone who thinks that carriers weren't going to raise their rates next year is being naive."

In addition to higher premiums, people can also expect to pay higher deductibles on the new policies, although under the new law the maximum, annual out-of-pocket expense is $6,350, Shields said.

Perhaps more concerning, Shields said, is that to keep costs down some insurance companies are more severely limiting the number of doctors policy holders can see. He said Blue Shield has reduced the size of its network of doctors by two-thirds and switched from being a preferred-provider organization, which allows policy holders to use doctors outside the network at a higher cost, to an exclusive provider network, which limits policy holders to using only doctors that belong to the network.

"With an EPO, the only doctors I may use are in Marin," Shields said. "If I want to go across the bridge to San Francisco and use Blue Shield doctors there, I will not have that covered at all."

Blue Shield could not be reached for comment.

In a prepared statement announcing Blue Shield's agreement to delay some of its policy cancellations, Insurance Commissioner Dave Jones said, "There is nothing in the health care reform law that requires insurers to narrow their provider networks, but some insurers are doing so, which means consumers will want to confirm that their doctors and hospitals are in the network before selecting new coverage."

Covered California announced Wednesday an estimated 370,000 individuals seeking coverage under the Affordable Care Act started applications in October. Since Oct. 1, more than 59,000 individuals have enrolled in Covered California health insurance plans.